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TR-8671A
John M. Bredemeyer [[l, President ,���guFFD(,f c Town Hall,53095 Main Rd. Michael J. Domino, Vice-President � � eie0y� P.O.Box 1179 • James F. King Southold,NY 11971 Charles J. Sanders : � Telephone(631)765-1892 o DaveBergen_____—._ .. ' ` �. Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. - INSPECTION SCHEDULE Pre-construction, silt fence 1st day of construction \/ % constructed /( Project complete, compliance inspection / /w iii ol/ John M.Bredemeyer III,President ��� � SOUR7 Town Hall Annex Michael J. Domino,Vice-President � ,; • l0 54375 Main Road It ;� ". 4 P.O. Box 1179 James F.King,Trustee Y Southold,New York 11971-0959 Dave Bergen,Trustee �` @ �c� �� Telephone(631) 765-1892 Charles J.Sanders,Trustee Fax(631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 8671A Date of Receipt of Application: August 11, 2015 Applicant: Peter G. Schaedel, Joanne Blum, William J. Schaedel, Jan M. Schaedel SCTM#: 1000-122-4-25 Project Location: 3830 Ole Jule Lane, Mattituck Date of Resolution/Issuance: September 16, 2015 Date of Expiration: September 16, 2017 Reviewed by: Trustee James F. King Project Description: To replace the existing ramp and floating dock with a 3'x12' aluminum ramp and a 5'x20' floating dock to be held with two (2) 6" diameter pilings; and re-position the ramp and dock to extend out in the center of the "U" shaped basin. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the project plan prepared by Joanne Blum &William Schaedel, received on August 11, 2015, and stamped approved on September 16, 2015. Special Conditions: None. Inspections: Final Inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required. This is not a determination from any other agency. dr,- 41/2% John M. Bredemeyer III, President Board of Trustees ' -'".. -,...'.-;'..."' ..-."..,:- '''.,..,'..-.--.,"-",. .,„t.., "„:'?. , :- • .,,, „. , ., 1. .,:' , - " „' ',,,,:,";,,:".°. ":,.,-+K.,'..::;,..,'„,:.-- ,---,•--.,,_•‘..• ,-,;',.1.,._,:-„;....- ;. , ''.,t', .: -- .-‘' . - - . ' - , ,r.,.., ‘''''- .' '- '''': . -4 ''.."..!':' ''' .: ' '": . - '* .- • .1';1 .7'.: . •;.: -, .. ;„ ' ..„ • , ,' '„:' , , '., '.'_,''7' '',',.: ':' ' ..„, " ' ';', '.. "...• ,;. 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' ' ''.'-''':;” '''''''''''''' '-'-'' ''-c':- TEL -, 765-1892 I, . i..,,,.i": .!--'..", ,",'',' -,.`"'.-`,,.:,\';'7i1-".C'. '4,4-I - ' ',`::j"-:-.':4 ',-.' : ,:,,' ,':'''' '...,'.-:. ' , .- • ' , , .: '..:.4 iS:11'ri :. ,'. .,r,;.: . '.,-' ,.',,^:- +.,47:: -'T.- -'' '' - '; '‘: -,;"".- ,',,, ' , ', ,'‘.'s ' ,,,,,.'-.1, ;''''i;- r''.:'.' *',,,‘'"''*'::,^tl''':-.^:', ) ,',•. -' ,'".,-'..-.-z- -''- '''''.': ' `-'''''-'' ' .. r ' '.:'',--"' -',' ':=','- '.", ' ,• , , ".' ' '' '' 't''''''' ":','''''' I".,','.',". ii.'-':-___1...Z_'_2:.1-.!;:_-,.,1:z',.:---,._ '—•-,--,- _ .._... - 1 t - t - • PLAN VIW 1n1I1A 1-0 i t oto of AA/ 20` x5'F 6 TI?J& Dom _18,.,'Mc PRQ\i E Li v Y , • OLE JUL1= LAME • ` 3003,. Suffolk . ei,•b„ 6 >:' r r i; _1,,-,, ,,2,‘. N k5l7cc •• c � ,. .rk .is ..ry Y • _ --1 Ls 4` ,0 G } p t. y �yl � s .y ti: 1 'c '' o�a' AIRPORT 1 �Z . I. 1 ,: / icer . G a' • {TS73•sY L...;,,,17 1'•n: �;:r' Ly 1',F '�f • 4. Lo r7. AUG 1 ;'._� _ 2015 )-. T.1-rte=te r r. ci. O c �rx: • e.i..74:-.1.= Notes: A-_- ' i •OJt701d riSt ' 2. _-.._. z 1,4,a _ 's fill v1/461ed•-"rn-15,cF slip. � , . , . 2)Da--l-Urn:ALW . —.r");_s,_ . 3)Timber•to be ccA treated • . 21.7 I Li/f/ 11,4"./.4 . •• - --- .. • . .• .i fl / a)Praperty location:3830 Ole Tule Ln., Matti-fuck;sCTM#1000-122-4-25 FEET =ma= ( • b)Ad jac -en owners: i 1 'c, �° 1. Edwards t ` �_. 2. i7ega!adenzi 1# 1 \ \,. fr4,r.t?OAD , pcc, _ Fa,z BoAT >, *� ?AMP aN}lw,t-c't {="f PER. i'E41.s:5 7'.i k t: •.3./--Gl ` y r---- ._—.1 --I 0,0'6: / ua e i. =rte :il -.16 . }� - • : AD.::: : i. ,. 041 t 1' - 1- 6,1144.0.r , • _•�..�,-----••.r. X� . ANkr/,94Y{r c '`; _.-_.•�. , 118111Lk/Ad go'xfr Fid 7_._.. • J c- Frepr,,5 ( ' )C,t� cin AND 12aK3 11 1N'1! r oil I t 2110E4 IIAg PN Pag15b . ! JAMESCREEK 02-X VIA -6)PAItIGE JOANNE BLU c& LIAM i SC A DEL ON JAMES C.'nEK, I MATTITUCK, SUFFOLK C0_, NY 'II SHEET 1 OF 2 2/17/99;4/8/99 II • .. . . . . SEcrio0 DMA IIISTALLATI6d of NEW So x ST foirritt oack: A0 knflip _ • . .:. S CALE:1"---10` - - . Ex.RposE ,• - , i E4:5;--.4r,-ick-isgalt5tro.,, ..::,:„ JL-------4i ,40 .- 1 VAX. :11)..7...a*..45.MAlip-ks,x....„,v,Fii, • 1-. •r2it,gilf...a,ke,c,K CA45M-le:27461 1---------------,, . . -- AlIKA-•••..a•-j-6.1. . 1111M1111111 -- i: -: ••• et' Lea.246.' • • • .,..•-,..r.gistrortt-3' -k 6 RA6E p4A-‘r - i . —ae•e-f 1,5 . - .bc,i6 . -. • • ' - a. • .. . i 1-f G ,• .1, ' ,' . I .:1.:( I 1 . ra-._ CTY6 2r- f',.. IF' 1 ';,,II V T...;. ii ' _: ,f - . . ..., . - AUG 1 1 2015 ' . Southold kngn Botti of Ttgstee4 - A PPM-WE:0 .4..-.Z PF ANTI 1..:"O.NOCI ars 4.3.E P.1LVIT NO. 1-..'23,5.7"-dAlrbldooe> "DATE . , — EN-CQ4;31.11.71HISTF it4C. . 132R 11.- 712-s;.: 131-0. • 5OLF:1-it.WreN; 5':'_ 11P1',73 516-283-63SO -- I I - . , prop05:ed DoCk-10 _ah /1 . JOANNE BLUM es WILLIAM SCHAEDEL ON JAMES CREEK, MATT/TUC , SUFFOLK CO., NY 1.SPIEET 2 OF 2 .2/17199;4/8/99 - .. .. . John Bredemeyer, President ,-�''guFFnt Town Hall Annex Michael J. Domino, Vice-President ,'�°° �cO°ys; 54375 Route 25 James F. King ;ti P.O. Box 1179 Charles J Sanders 'o ,' Southold, NY 11971 Dave Bergen yOl ,� �a°!�'� Telephone (631) 765-1892 Fax (631) 765-6641 Southold Town Board of Trustees Field Inspection/Work Session Report Date/Time: 6 D '-r l 8 So PETER SCHAEDEL, JOANNE BLUM, WILLIAM SCHAEDEL & JAN SCHAEDEL request an Administrative Permit to replace the existing ramp and floating dock with a 3'x12' aluminum ramp and a 5'x20' floating dock to be held with two (2) 6" diameter pilings; and re-position the ramp and dock to extend out in the center of the "U" shaped basin. Located: 3830 Ole Jule Lane, Mattituck. SCTM# 122-4-25 Type of area to be impacted: MFS Saltwater Wetland Freshwater Wetland Sound Bay Distance of proposed work to edge of wetland Part of Town Code proposed work falls under: %Chapt.275 Chapt. 111 other TypApplication: Wetland Coastal Erosion Amendment Administrative Emergency Pre-Submission Violation Notice of Hearing card posted on property: Yes NoNot Applicable Storm Water Management Review: Yes No Not Applicable Info needed: Modifications: Conditions: Present Were: J. Bredemeyer M. Domino `rJ. King D. Bergen C. Sanders Bay Constablepp Other td Form filled out in the field by , k1, U (1 Mailed/Faxed to: Date: -_- 4. =: I Y~ 4 •►•vt • -} a. .........................______4104._. _ _ — ,.. '''''' .,,,•-•.,,Z•iiiirlika.4„---- _ .tom — � � ..�. E. � •. -- ..moi. • • • - J • 4111.2111111 • /1 :- .4:'-''‘ -- _, ....!.-..., . „.. \" - q ' _ •• • . . _ • -- - — ,•-.... ., ., , *: ,.. •., .. f- . •,-‘,. .,-• -.----r.:.•... .•.•••••-:,',.. .5.:::;:•-••.'. . . . . 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FOR FCL NO1 BEEBEC NO,A O .0 1ORPCL 51 1 1 Loi�lA 7 4.00- , 1 I O � 41, s1.a+1, . � I p; / '''''',:., •*: ''''' N / - z.:-...4 ,,,,,,,,9„„, 0,0 . ,--, ,.. , , ..., ,,,, , , ,...„ 4,„v, , . .. / / . A 4 xxr ''''Ir MATCH UNE � 1E wtp—r—Z— -LT.E j/ eP`I ••••• v SE BEC NO 120 /'y ° W \ NOTE AN APPARENT OVERLAP CONDITION /t4� 0,604\ EXISTS WITHIN BLOCK 06 BETWEEN PARCELS x5.46]56 E d..w.�.... —.Z-- .,..,...�.,,,. (211 ...w O "__ ". 1 NOTICE ,+"m'w COUNTY OF SUFFOLK © e Ilp 82 6w.81 souTNoto SECTION NO E .�..,d ...._ _.: - .. ._....,..-- Property Service Agency v »,. Real ax . / '�®F SOj OFFICE LOCATION: / MAILING ADDRESS: Town Hall Annexl® t �® • P.O. Box 1179 54375 State Route 25 • Southold, NY 11971 (cor. Main Rd. &Youngs Ave.) Southold, NY 11971 @,�� Telephone: 631 765-1938 • ,•• own* 0 • LOCAL WATERFRONT REVITALIZATION PROGRAM TOWN OF SOUTHOLD MEMORANDUM DECEIVE in I U RI SEP 1 1 2015 To: John Bredemeyer, President Town of Southold Board of Trustees Southold Town From: Mark Terry, Principal Planner Biatd°f'r'steAs LWRP Coordinator Date: September 11, 2015 Re: Proposed Wetland Permit for PETER SCHAEDEL, JOANNE BLUM, WILLIAM SCHAEDEL & JAN SCHAEDEL SCTM# 1000-122-4-25 PETER SCHAEDEL, JOANNE BLUM, WILLIAM SCHAEDEL & JAN SCHAEDEL request an Administrative Permit to replace the existing ramp and floating dock with a 3'x12' aluminum ramp and a 5'x20' floating dock to be held with two (2) 6" diameter pilings; and re-position the ramp and dock to extend out in the center of the "U" shaped basin. Located: 3830 Ole Jule Lane, Mattituck. SCTM# 122- 4-25 The proposed action has been reviewed to Chapter 268, Waterfront Consistency Review of the Town of Southold Town Code and the Local Waterfront Revitalization Program (LWRP) Policy Standards. Based upon the information provided on the LWRP Consistency Assessment Form submitted to this department, as well as the records available to me, it is my recommendation that the proposed action is INCONSISTENT with LWRP Policy 6, specifically 6.3 (below) and therefore, INCONSISTENT with the LWRP. 6.3 Protect and restore tidal and freshwater wetlands. • A. Comply with statutory and regulatory requirements of the Southold Town Board of Trustees laws and regulations for all Andros Patent and other lands under their jurisdiction 1. Comply with Trustee regulations and recommendations as set forth in Trustee permit conditions. The structures were not constructed with the benefit of a Board of Trustees review or permit. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney a. Protect existing indigenous plants from loss or disturbance to the extent practical. In the event that the action is approved it is recommended that the Board: 1. Minimize the clearing of trees to the greatest extent practicable. 2. Require that a 50'wide non-disturbance buffer be required landward from the wetland line. Pursuant to Chapter 268, the Board of Trustees shall consider this recommendation in preparing its written determination regarding the consistency of the proposed action. Cc: Lori Hulse, Assistant Town Attorney Oe.1 Lr` -- r -fe John M.Bredemeyer III,President itC •® 40 Town Hall Annex Michael J.Domino,Vice-President • i �4 !'' ' 54375 Main Road tip-slit P.O.Box 1179 James F.King,Trustee Southold,New York 11971-0959 Dave Bergen,Trustee a Q Charles J.Sanders,Trustee Y Telephone(631)765-1892 lyC Fax(631)765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Office Use Only _Coastal Erosion Permit Application �i r E ,r Wetland Permit Application � if) ,, Administrative Permit L i r iLJ Amendment/Transfer/ xtension ? AUG 1 1 2015 '' Received Application: /I I Received Fee:$ AV ._.._.I Completed Application: ,?fl S�tuthoid70;1 ' Incomplete: • if f' >e• SEQRA Classification: Type I Type II Unlisted -- - Coordination:(date sent): 'F'LWRP Consistency Assessment Form: 9l11)/0"/ . CAC Referral Sent: I Date of Inspection: Receipt of CAC Repo : _Lead Agency Determination: Technical Review: 0 Public Hearing Held: q` q/- Resolution: , Name of Applicant: Peter G. Schaedel,Joanne Blum,William T. Schaedel,Tan M. Schaedel Mailing Address: 1711 Parklake Village Katy,Texas 77450 Phone Number: +1 832 279-1879 Suffolk County Tax Map Number: 1000- 122 -4 -25 Property Location: 3830 Ole Jule Lane Mattituck,NY 11952 '! Closest cross street is Kraus Road _ (provide LILCO Pole#, distance to cross streets,and location) d\A/ 1-an //).-AGENT: � (If applicable) _�rraaaa, i i Address: Phone:--4-1-602- ''f Cantrell, Elizabeth From: Peter Schaedel <pschaedel@vereseninc.com> Sent: Wednesday,August 12, 2015 10:40 AM To: Cantrell, Elizabeth Subject: Administrative Permit Application - Board of Trustees -Install New Floating Dock at 3830 Ole Jule Lane Mattituck Attachments: Dock Disclosure Fm Signed.pdf Hi Elizabeth: Thank you for your help on the phone this morning. Attached please find the signed Transactional Disclosure Form. Grateful if you can print it out and add it to my existing application. The following is an updated Project Description to replace the current PD in three locations in the permit application: • Page 3 of 17—General Data • Pager 5 of 17—Appendix B Short Environmental Assessment Form • Page 12 of 17-LWRP Consistency Assessment Form Updated Project Description Replace 5'x 20'floating dock and 3'x 12' ramp shown in July, 1999 NYS DEC permit with new aluminum 5'x 20'floating dock and 3'x 12' ramp. Existing floating dock was damaged beyond repair due to severe ice buildup from past winter. New floating dock and ramp to be installed on centerline of existing U shaped basin with dock held in position by two 6"x 20' long pilings as per attached plan view. You will delete Richard W. Reinken as the agent on page 2 of 17 of the permit application. I will place a stake marker in the water at the location of the end of the float furthest away from the bulkhead prior to 9 September when the Trustees will carry out their inspection on the property. Next hearing date of Board of Trustees will be Wednesday evening, 16 September. I do not need to be present at the hearing. - Grateful if you could respond to this e-mail to confirm receipt. Please contact me with any further questions via e-mail or at cell phone number below. Thank you again for your assistance. Thanks and best regards, Peter Peter Schaedel Director, Marine P. +1-713-400-2810 C +1 832-279-1879 . E pschaedel(c�vereseninc.com www. _Cc inc_com w _ vnimjordancovaing.com _.. This transmission(including any attachments)may contain confidential information,privileged material,or constitute non-public information Any use of this information by anyone other than the intended recipient is prohibited If you have received this transmission in error,please immediately reply to the 1 ( Bo of Trustees Application GENERAL DATA Land Area(in square feet): Approx.21,770 ft2 Area Zoning: Single Family Residence Previous use of property: Single Family Residence Intended use of property: Single Family Residence Covenants and Restrictions on property? Yes X No If"Yes",please provide a copy. Will this project require a Building Permit as per Town Code? Yes X No If"Yes",be advised this application will be reviewed by the Building Dept.prior to a Board of Trustee review and Elevation Plans will be required. Does this project require a variance from the Zoning Board of Appeals? Yes X No If"Yes",please provide copy of decision. Will this project require any demolition as per Town Code or as determined by the Building Dept.? Yes X _ No Does the structure(s)on property have a valid Certificate of Occupancy? X Yes No Prior permits/approvals for site improvements: Agency Date NYS Dept of Environmental Conservation July 14, 1999 No prior permits/approvals for site improvements. Has any permit/approval ever been revoked or suspended by a governmental agency? X No Yes If yes,provide explanation: Project Description(use attachments if necessary): Replace 5'x 20'floating dock and 3'x 12'ramp shown in July, 1999 NYS DEC permit with new aluminium floating dock and ramp of similar dimensions. Existing floating dock was damaged beyond repair due to severe ice buildup from past winter. New floating dock and ramp to be installed on centerline of existing U shaped basin as per attached plan view. • BaC r•L of Trustees Application - WETLAND/TRUSTEE LANDS APPLICATION DATA Purpose of the proposed operations: Remove debris and damaged pilings from original floating dock. Install new aluminium floating dock and ramp in centerline of U shaped basin to allow better utilization of float with space of a boat on either side. Area of wetlands on lot: N/A square feet Percent coverage of lot: N/A Closest distance between nearest existing structure and upland edge of wetlands: N/A feet Closest distance between nearest proposed structure and upland edge of wetlands: N/A feet Does the project involve excavation or filling? X No Yes If yes,how much material will be excavated? cubic yards How much material will be filled? 0 cubic yards Depth of which material will be removed or deposited: feet Proposed slope throughout the area of operations: Manner in which material will be removed or deposited: No material will be removed or deposited. Statement of the effect,if any, on the wetlands and tidal waters of the town that may result by reason of such proposed operations(use attachments if appropriate): Project will have no impact on any wetlands or tidal waters. 617.20 Appendix B Short Environmental Assessment Form Instructions for Completing Part I -Project Information. The applicant or project sponsor is responsible for the completion of Part 1. Responses become part of the application for approval or funding,are subject to public review,and may be subject to further verification. Complete Part I based on information currently available. If additional research or investigation would be needed to fully respond to any item,please answer as thoroughly as possible based on current information. Complete all items in Part 1. You may also provide any additional information which you believe will be needed by or useful to the lead agency;attach additional pages as necessary to supplement any item. Part 1-Project and Sponsor Information Name of Action or Project: Replace existing damaged floating dock&ramp and install in new location. Project Location(describe,and attach a location map): See attached plan view of installation of new floating dock and ramp. Brief Description of Proposed Action: Replace 5 x 20'floating dock and 3'x 12'ramp shown in July, 1999 NYS DEC permit with new aluminium floating dock and ramp of similar dimensions.Existing floating dock was damaged beyond repair due to severe ice buildup from past winter.New floating dock and ramp to be installed on centerline of existing U shaped basin as per attached plan view. Name of Applicant or Sponsor: Telephone: +1 832 279-1879 Peter G. SchaedelJoanne Blum,William J.Schaedel,Jan M. Si Hdi8 pgschaedel@aol.com Address: 1711 Parklake Village City/PO: State: Zip Code: Katy Texas 77450 1.Does the proposed action only involve the legislative adoption of a plan,local law,ordinance, NO YES administrative rule,or regulation? If Yes,attach a narrative description of the intent of the proposed action and the environmental resources that bL may be affected in the municipality and proceed to Part 2. If no,continue to question 2. 2. Does the proposed action require a permit,approval or funding from any other governmental Agency? NO YES If Yes,list agency(s)name and permit or approval: ❑ X 3.a.Total acreage of the site of the proposed action? 0.5 acres b.Total acreage to be physically disturbed? 0.0 acres c.Total acreage(project site and any contiguous properties)owned or controlled by the applicant or project sponsor? 0.5 acres 4. Check all land uses that occur on,adjoining and near the proposed action. ❑Urban 0 Rural(non-agriculture) 0 Industrial 0 Commercial ®Residential(suburban) ❑Forest ❑Agriculture ❑Aquatic ❑Other(specify): ❑Parkland Page 1 of 4 5 Is the proposed action, NO YES N/A a.A permitted use under the zoning regulations X J ( I b.Consistent with the adopted comprehensive plan? El X L® 6. Is the proposed action consistent with the predominant character of the existing built or natural NO YES landscape? X 7. Is the site of the proposed action located in,or does it adjoin,a state listed Critical Environmental Area? NO YES If Yes,identify: X ❑ '8. a.Will the proposed action result in a substantial increase in traffic above present levels? NO YES 0 ❑. b.Are public transportation service(s)available at or near the site of the proposed action? 0 -0 c.Are any pedestrian accommodations or bicycle routes available on or near site of the proposed action? X 9.Does the proposed action meet or exceed the state energy code requirements? NO YES If the proposed action will exceed requirements,describe design features and technologies: ❑ N/A X 10. Will the proposed action connect to an existing public/private water supply? NO YES If No,describe method for providing potable water: N/A X� ❑ 11.Will the proposed action connect to existing wastewater utilities? NO YES If No,describe method for providing wastewater treatment: N/A X ' I 12. a.Does the site contain a structure that is listed on either the State or National Register of Historic NO YES Places? X 1-1 b.Is the proposed action located in an archeological sensitive area? X 13.a.Does any portion of the site of the proposed action,or lands adjoining the proposed action,contain NO YES wetlands or other waterbodies regulated by a federal,state or local agency? [1 x b.Would the proposed action physically alter,or encroach into,any existing wetland or waterbody? (T I El If Yes,identify the wetland or waterbody and extent of alterations in square feet or acres: 'f' 14. identify the typical habitat types that occur on,or are likely to be found on the project site. Check all that apply: ®Shoreline 0 Forest 0 Agricultural/grasslands ❑Early mid-successional ❑ Wetland ❑Urban 1.1 Suburban 15.Does the site of the proposed action contain any species of animal,or associated habitats,listed NO YES by the State or Federal government as threatened or endangered? ❑ 16.Is the project site located in the 100 year flood plain? [NO YES 17.Will the proposed action create storm water discharge,either from point or non-point sources? NO YES If Yes, a.Will storm water discharges flow to adjacent properties? ❑NO DYES X El b.Will storm water discharges be directed to established conveyance systems runoff and storm drains)? If Yes,briefly describe: NO YES N/A Page 2 of 4 IS.Does the proposed action include construction or other activities that result in the impoundment of NO YES water or other liquids(e.g.retention pond,waste lagoon,dam)? If Yes,explain purpose and size: nn 19.Has the site of the proposed action or an adjoining property been the location of an active or closed NO YES solid waste management facility? If Yes,describe: f�1 j1 20.Has the site of the proposed action or an adjoining property been the subject of remediation(ongoing or NO YES completed)for hazardous waste? If Yes,describe: l • I AFFIRM THAT THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE Applicant/sponsor name: Peter G.Schaedel Date: 9 August 2015 Signature: ckb_ ���ad Part 2-Impact Assessment. The Lead Agency is responsible for the completion of Part 2. Answer all of the.following questions in Part 2 using the information contained in Part 1 and other materials submitted by the project sponsor or otherwise available to the reviewer. When answering the questions the reviewer should be guided by the concept"Have my responses been reasonable considering the scale and context of the proposed action?" No,or Moderate small to large impact impact may may occur occur I. Will the proposed action create a material conflict with an adopted land use plan or zoning �i regulations? ' 2. Will the proposed action result in a change in the use or intensity of use of land? 3. Will the proposed action impair the character or quality of the existing community? 4. Will the proposed action have an impact on the environmental characteristics that caused the ! n establishment of a Critical Environmental Area(CEA)? 5. Will the proposed action result in an adverse change in the existing level of traffic or —7( affect existing infrastructure for mass transit,biking or walkway? ��JJ 6. Will the proposed action cause an increase in the use of energy and it fails to incorporate 71 reasonably available energy conservation or renewable energy opportunities? 7. Will the proposed action impact existing: ❑ a.public/private water supplies? b.public/private wastewater treatment utilities? l n 8. Will the proposed action impair the character or quality of important historic,archaeological, ( n architectural or aesthetic resources? l 9. Will the proposed action result in an adverse change to natural resources(e.g.,wetlands, waterbodies,groundwater,air quality,flora and fauna)? Page 3 of 4 . No,or Moderate small to large impact impact may may occur occur 10. Will the proposed action result in an increase in the potential for erosion,flooding or drainage ❑ problems? 11. Will the proposed action create a hazard to environmental resources or human health? 1 Part 3-Determination of significance. The Lead Agency is responsible for the completion of Part 3. For every question in Part 2 that was answered"moderate to large impact may occur",or if there is a need to explain why a particular element of the proposed action may or will not result in a significant adverse environmental impact,please complete Part 3. Part 3 should,in sufficient detail,identify the impact,including any measures or design elements that have been included by the project sponsor to avoid or reduce impacts. Part 3 should also explain how the lead agency determined that the impact may or will not be significant.Each potential impact should be assessed considering its setting,probability of occurring, duration,irreversibility,geographic scope and magnitude. Also consider the potential for short-term,long-term and cumulative impacts. • L_) Check this box if you have determined,based on the information and analysis above,and any supporting documentation, t�l that the proposed action may result in one or more potentially large or significant adverse impacts and an environmental impact statement is required. eck this box if you have determined,based on the information and analysis above,and any supporting documentation, that the proposed action will not result in any significant adverse environmentalliimmpacts. Town of Southold-Board of Trustees a ✓�j� Name of Lead Agency Date /c'erW President Print or Typeame of R ponsible Officer in Lead Agency Title of Responsible Officer I, � / Sy `e of Re so �a Officer in Lead 'tgency Signature of Preparer(if different from Responsible Officer) PRINT Page 4 of 4 Board of Trustees Application AFFIDAVIT Peter G.Schaedel BEING DULY SWORN DEPOSES AND AFFIRMS THAT HFJSHE IS TILE APPLICANT FOR THE ABOVE DESCRIBED PERMIT(S)AND THAT ALL STATEMENTS CONTAINED HEREIN ARE TRUE TO THE BEST OF HIS/HER KNOWLEDGE AND BELIEF,AND THAT ALL WORK WILL BE DONE IN THE MANNER SET FORTH IN THIS APPLICATION AND AS MAY BE APPROVED BY THE SOUTHOLD TOWN BOARD OF TRUSTEES. THE APPLICANT AGREES TO HOLD THE TOWN OF SOUTHOLD AND THE BOARD OF TRUSTEES HARMLESS AND FREE FROM ANY AND ALL DAMAGES AND CLAIMS ARISING UNDER OR BY VIRTUE OF SAID PERMIT(S),IF GRANTED. IN COMPLETING THIS APPLICATION,I HEREBY AUTHORIZE THE TRUSTEES,THEIR AGENT(S)OR REPRESENTATIVES,INCLUDING THE CONSERVATION ADVISORY COUNCIL,TO ENTER ONTO MY PROPERTY TO INSPECT THE PREMISES IN CONJUNCTION WITH THIS APPLICATION, INCLUDING A FINAL INSPECTION. I FURTHER AUTHORIZE THE BOARD OF TRUSTEES TO ENTER ONTO MY PROPERTY AND AS REQUIRED TO INSURE COMPLIANCE WITH ANY CONDITION OF ANY WETLAND OR COASTAL EROSION PERMIT ISSUED BY THE BOARD OF TRUSTEES DURING THE TERM OF THE PERMIT. 4sAJ . Signature of Property Owner SWORN TO BEFORE ME THIS 11th DAY OF August ,2015 LEE MARTIN My Commiaaton,ExpHri CY:if,c/fAV4 *4&4January2 .2016 ' otary Public %%afoot APPLICANT/AGENT/EEPRESENTATIVE TRANSACTIONAL DISCLOSURE FORM The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of(nwn Officers and employees.The purpose of this form is to provide intbrmafion which can alert the town el-possible conflicts of interest and allow it to take whatever action is necessary to avoid same. YOUR NAME: Peter G. Schaedel (Last name,first name,.rpiddle initial,unless you are applying in the name of someone else or other entity,such as a company.If so,indicate,the other person's or company's name.) NAME OF APPLICATION: (Check all that apply.) Tax grievance Building Variance Trustee • Change of Zone Coastal Erosion Approval of plat Mooring Exemption from plat or official map Planning Other (lf"Other,name the activity.) Replace existing damaged float dock&ramiLand install in new location. Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of the Town of Southold? "Relationship"includes by blood,marriage,or business interest."Business interest"•means a business, including a partnership,in which the town officer or employee has even a partial ownership of(or employment by)a corporation in which the town officer or employee owns more than 5%of the shares. YES NO X If you answered"YES",complete the balance of this form and date and sign where indicated. Name of person employed by the Town of Southold Title or position of that person Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the appropriate line A)through D)and/or describe in the space provided. The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply): A)the owner of greater than 5%of the shares of the corporate stock of the applicant (when the applicant is a corporation); B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation); C)an officer,director,partner,or employee of the applicant;or D)the actual applicant. DESCRIPTION OF RELATIONSHIP Submitted this II day:�uO- 200 is- Signature Signature Print Name Pink a. SGHAE: EL Form TS I 1 � Town of Southold LWRP CONSISTENCY ASSESSMENT FORM A. INSTRUCTIONS 1,. All applicants for permits* including Town of Southold agencies, shall complete this CCAF for proposed actions that are subject to the Town of Southold Waterfront Consistency Review Law. This assessment is intended to supplement other information used by a Town of Southold agency in making a determination of consistency. *Except minor exempt actions including Building Permits and other ministerial permits not located within the Coastal Erosion Hazard Area. 2. Before answering the questions in Section C, the preparer of this form should review the exempt minor action list, policies and explanations of each policy contained in the Town of Southold Local Waterfront Revitalization Program. A proposed action will be evaluated as to its significant beneficial and adverse effects upon the coastal area(which includes all of Southold Town). 3. If any question in Section C on this form is answered "yes" or "no", then the proposed action will affect the achievement of the LWRP policy standards and conditions contained in the consistency review law. Thus, each answer must be explained in detail, listing both supporting and non- supporting facts. If an action cannot be certified as consistent with the LWRP policy standards and conditions,it shall not be undertaken. A copy of the LWRP is available in the following places: online at the Town of Southold's website (southoldtown.northfork.net), the Board of Trustees Office, the Planning Department, all local libraries and the Town Clerk's office. B. DESCRIPTION OF SITE AND PROPOSED ACTION SCTM# 1000 - 122 - 4 -025 PROJECT NAME Replace floating dock&ramp damaged due to severe winter ice&move to centerline of Basin The Application has been submitted to(check appropriate response): Town Board FlPlanning oard El Building Building Dept. l I Board of Trustees Fl 1. Category of Town of Southold agency action(check appropriate response): (a) Action undertaken directly by Town agency(e.g. capital construction,planning activity,agency regulation,land transaction) 11 (b) Financial assistance(e.g. grant,loan,subsidy) (c) Permit,approval,license,certification: Nature and extent of action: Replace 5'x 20'floating dock and 3'x 12'ramp shown in July, 1999 NYS DEC permit with new aluminium floating dock and ramp of similar dimensions.Existing floating dock was damaged beyond repair due to severe ice buildup from past winter. New floating dock and ramp to be installed on centerline of existing U shaped basin. 1 Location of action: Single famil residence 3830 Ole Jule Lane Mattituck,NY 11952 Site acreage: 0.5 acres Present land use: Single family residence Present zoning classification: Single family residence 2. If an application for the proposed action has been filed with the Town of Southold agency, the following information shall be provided: (a) Name of applicant: Peter G. Schaedel,Joanne Blum,William J. Schaedel,Jan M. Schaedel (b) Mailing address:_ 1711 Parklake Village Katy,TX 77450 (c) Telephone number: Area Code( ) +1 832 279-1879 ; (d) Application number,if any: Will the action be directly undertaken,require funding, or approval by a state or federal agency? Yes No X, If yes,which state or federal agency? C. Evaluate the project to the following policies by analyzing how the project will further support or not support the policies. Provide all proposed Best Management Pr.:ctices that will further each policy. Incomplete answers will require that the form be returned for completion. DEVELOPED COAST POLICY Policy I. Foster a pattern of development in the Town of Southold that enhances community character, preserves open space, makes efficient use of infrastructure,makes beneficial use of a coastal location,and minimizes adverse effects of development. See LWRP Section III—Policies; Page 2 for evaluation criteria. n Yes n, No n Not Applicable No development will be taking place. Attach additional sheets if necessary Policy 2. Protect and preserve historic and archaeological resources of the Town of Southold. See LWRP Section III—Policies Pages 3 through 6 for evaluation criteria Yes No El Not Applicable No historic or archaeological resource-s-are present on the property. Attach additional sheets if necessary Policy 3. Enhance visual quality and protect scenic resources throughout the Town of Southold. See LWRP Section III—Policies Pages 6 through 7 for evaluation criteria Yes ❑ No n Not Applicable There will be no change in visual quality or to scenic resources due to the replacement of the existing floating dock. Attach additional sheets if necessary NATURAL COAST POLICIES Policy 4. Minimize loss of life, structures, and natural resources from flooding and erosion. See LWRP Section III—Policies Pages 8 through 16 for evaluation criteria 0 Yes No 0 Not Applicable Replacement of existing floating dock will have no impact on possible flooding or erosion. Attach additional sheets if necessary "- Policy 5. Protect and improve water quality and supply in the Town of,Southold. See LWRP Section III —Policies Pages 16 through 21 for evaluation criteria Yes n No ❑Not Applicable Replacement of existing floating dock will have no impact on water quality and supply in the Town of Southold. Attach additional sheets if necessary Policy 6. Protect and restore the quality and function of the Town of Southold ecosystems including Significant Coastal Fish and Wildlife Habitats and wetlands. See LWRP Section III—Policies; Pages 22 through 32 for evaluation criteria. n n n Yes No Not Applicable Replacment of existing floating dock will have no impact on coastal fish and wildlife habitats and wetlands. Attach additional sheets if necessary Policy 7. Protect and improve air quality in the Town of Southold. See LWRP Section HI — Policies Pages 32 through 34 for evaluation criteria. H Yes [ No X Not Applicable Replacement of existing floating dock will have no impact on air quality in the Town of Southold. _ \ Attach additional sheets if necessary Policy 8. Minimize environmental degradation in Town of Southold from solid waste and hazardous substances and wastes. See LWRP Section III—Policies; Pages 34 through 38 for evaluation criteria. ri Yes No El Not Applicable Replacement of existing floating dock will have no impact on environmental degredation from solid or hazardous waste. PUBLIC COAST POLICIES Policy 9. Provide for public access to, and recreational use of, coastal waters, public lands, and public resources of the Town of Southold. See LWRP Section III—Policies; Pages 38 through 46 for evaluation criteria. n 1 I YeJ I No El Not Applicable Location is a private residence and project will have no impact on public access to and recreational use of coastal waters,public lands,and public resources in the Town of Southold. • Attach additional sheets if necessary �~ l a � WORKING COAST POLICIES Policy 10. Protect Southold°s water-dependent uses and promote siting of new water-dependent uses in suitable locations. See LWRP Section III—Policies; Pages 47 through 56 for evaluation criteria. X Yes ❑ No n Not Applicable Existing floating dock is already permitted as per the attached NYS DEC permit dated July 9, 1999.By authorizing replacement of a severly damaged floating dock and movement to centerline of existing U shaped basin,the Board of Trustees is promoting a safer means of access to personal recreational boats in suitable locations. Attach additional sheets if necessary Policy 11. Promote sustainable use of living marine resources in Long Island Sound, the Peconic Estuary and Town waters. See LWRP Section III—Policies; Pages 57 through 62 for evaluation criteria. Yes 1 No X❑ Not Applicable Replacement of existing floating dock will have no impact on existing living marine resources in James Creek. Attach additional sheets if necessary Policy 12. Protect agricultural lands in the Town of Southold. See LWRP Section III—Policies; Pages 62 through 65 for evaluation criteria. LI Yes l h6I No Not Applicable Replacement of existing floating dock will have no impact on agricultural lands in the Town of Southold. Attach additional sheets if necessary Policy 13. Promote appropriate use and development of energy and mineral resources. See LWRP Section III—Policies; Pages 65 through 68 for evaluation criteria. H Yes NoX❑ Not Applicable Replacement of existing floating dock will have no impact on the development of energy and mineral resources in the Town of Southold. PREPARED Ey Peter G.Schaedel TITLE Applicant DATE 10 August 2015